On Sex Reassignment Surgery (SRS) or, Does God Make Mistakes? (Part I)

This post turned out to be really long, and I can’t think of a good way to shorten it.  So, I’ve posted it in two parts.  If you read one, read both, as the overarching argument leads directly through the two of them.  Find the next part here.

The million-dollar question: does God make mistakes?

Short answer?  I don’t think He does, but that’s hardly all the story, so read on!

Let’s start by clarifying what Sex Reassignment Surgery (hereafter called SRS) is: it’s the process of surgically altering genitals and other secondary sexual characteristics to more closely resemble another sex.  Treatment can be divided into two parts, plastic surgeries (to change, remove, reshape genitals or other secondary sexual characteristics) and hormone treatments (where androgens and estrogens are blocked or increased in the body to match those of the desired gender, also resulting in physical changes).  As there are varied physical differences between men and women, all of the different ways of treatment are grouped under this label, and knowing that someone has pursued SRS doesn’t contain any detail about what sexual characteristics have been treated or in what manner.

Obviously, there are limitations to this practice and nothing in the actual chromosomal and genetic makeup of the body is changed, just ‘surface’ features.  SRS requires multiple surgeries, is expensive, and is often not covered by medical insurance policies.  Plus, like any surgical procedure, there is a risk of other complications.

So why would anyone want this?

People whose gender identity differs from their biological gender feel differently about their bodies than people whose gender identity and biological gender are aligned.  For me personally this misalignment has caused many varied, negative emotions.  I’ve felt disconnected from my body (like it’s not me), frustrated, angry, sad, and I’ve felt a huge amount of discouragement and hopelessness.  My body’s gender has disgusted me, and it at one point contributed to some dangerous, irrational thoughts and plans.

In short, I don’t think it’s good for gender identity and biological gender to be out of whack.  At least I can’t come up with anything really positive that I’ve experienced from it.  Gender is a baseline identifier of a person and seems to crop up constantly in ways that we view ourselves and how others view and interact with us.

The best analogy I’ve thought of for this connection between the body’s gender and one’s gender identity is something like power steering or power brakes on a car.  When these systems are functional, they make driving much easier and typically go unnoticed.  In fact, many young drivers won’t even realize that their steering or braking is being mechanically assisted.  But the moment the system fails, one can hardly drive without being made aware of it.  Sure, without power steering or power brakes you can still steer and stop, but it’s much less elegant and much more difficult.

For me, the disconnect I feel between my identity and my body works very much in this way.  I’ll go about my daily business and then inevitably something will happen that reminds me that I’m male.  It could be the way someone addresses or talks to me.  It could be the sight of my own body.  It could be having to use a public, gender-segregated restroom.  Even just seeing a woman can remind me of what I’m not.  I don’t think I’ve yet discovered all the ways that I can be reminded.  But regardless of how it happens, it’s always disturbing and jarring.  It’s never pleasant.

Mind over matter?

As I talk about a little here, gender dysphoria is undergoing some transition (ha!) in how it’s being viewed by psychologists.  Historically it’s been treated as a mental condition, in which the problem is viewed as lying in the brain, i.e. one’s gender identity is flawed.  Increasingly, especially among transgender individuals and allies, gender dysphoria is being viewed as a birth defect in which the gender of the body is what is wrong and needs to be fixed to align to the psyche.

Trying to decide really what side of the equation is ‘faulty’ is a fascinating and incredibly complex question that deserves its own post, so I won’t really delve into it more here.  (But expect further exploration at some future point!)  As it stands now, we really don’t know the cause of gender dysphoria, whether it’s a mental illness, physical defect, or something completely different.

I will say, that as someone that experiences gender dysphoria, I feel mentally healthy.  I don’t feel like my mind is ill.  I don’t feel like my sense of identity, even with respect to my gender, is messed up.  To me, the gender of my body seems wrong.  I can understand, though, how someone observing me would probably take the opposite stance as my body is clearly male and has no discernible issues.

Weren’t we supposed to be talking about SRS?

Yes, we’re getting there.  The point is, it sucks to have gender dysphoria.  It really sucks, and I think it’s not exaggerating to say that it can be as debilitating as some physical disabilities.  That’s where SRS comes into play.  These procedures attempt to minimize the negative and sucky effects of gender dysphoria by bringing the body in line with one’s gender identity.

As I’ve already discussed a little, there are pros and cons to SRS.  On the up side, I believe it can go a long way into helping a gender dysphoric individual feel better about his or her body.  If done well, it can also help others see the individual as the gender that they identify as, eliciting more appropriate social interactions.

These benefits probably cannot be over-emphasized.  Like with the power steering analogy, if you’re comfortable with your body’s gender, you’ve probably never experienced what it’s like to have your car’s power steering fail.  If you experience gender dysphoria, it’s like the power steering hasn’t ever worked.  The single (but huge) benefit of feeling comfortable and satisfied with one’s gender likely can’t be accurately assessed by outside observation.

There have probably been some scientific studies to investigate satisfaction and quality of life ratings by individuals before and after SRS.  I’m lazy and not going to look them up now.  So I’m going out on an unsupported limb here, but I’d be very surprised if the data overwhelmingly said that SRS patients felt worse about themselves after the procedures.  (If you do have reliable data for either side, direct me towards it in the comments please!)

For my purposes here, though, it’s not necessary, because if someone gets SRS and is happier after than they were before, then that’s a benefit of the procedure, and one that can’t be qualified easily.

But there’s also the not-so-good…

Of course, there are also some cons with SRS.  Complete sexual transitions involve not only genital restructuring, but also secondary sexual characteristics which can also be complicated and time-consuming.  Like I mentioned already, these procedures are expensive, still relatively rare, and generally not covered by medical insurances.

Aside from the financial costs, there are also social costs.  In spite of better plastic surgery techniques, surgeons can only attempt to recreate the beauty and elegance of the human body.  Not all surgeries result in someone that’s ‘passable’ as the desired gender, and much is dependent upon the skill of the surgeon and how masculine or feminine the individual appeared to begin with.  Individuals that don’t ‘pass’ well can be subject to abuse or marginalization by our misunderstanding society.

A final downside that I think is sometimes overlooked is the one I want to focus on: that ultimately SRS is not a cure for gender dysphoria.  For all the good that SRS does, it’s not essentially different than putting on an expensive wig.  It doesn’t change the actual biological gender of the body, it just reshapes the genitals and other secondary sexual characteristics to more closely resemble those of the opposite gender.

I suspect that most SRS patients or others who have investigated it realize this, that SRS is still an ill-fitting band-aid.  Now if you’re bleeding to death, an ill-fitting band-aid is better than no band-aid at all.  Sometimes, though, I wonder if you’re not bleeding too terribly, if one is better served by holding out for the cure.  I’ll talk about this more in a minute.

Million-dollar question time!

It’s time for morality to enter the picture.  If you don’t believe in God, then from here on out you might not get much from what I have to say, since most of it will be based on the assumption that God exists, that we are His children, and that there’s more to life than just our mortality and the here and now.

If there is a higher power that is omniscient and omnipotent, then clearly this being doesn’t make mistakes and accidentally send spirits to the wrong body.  I don’t believe that my male body was an accident.  That’s not to say I have any idea why I’m male, because I don’t.  It’s literally been the bane of my existence.  But I think it was intentional rather than accidental.  In addition, I think that my Heavenly Father loves me and didn’t do this as a punishment or oversight.  (To be fair, my body’s gender has also allowed some pretty awesome blessings, too, like the ability to be married to my wife and my five amazing children – both things I wouldn’t be able to have and still be a Mormon in good standing if I were female.)

But don’t get ahead of me, because when I say that I don’t believe my body’s gender is an accident, I mean only that.  It doesn’t mean that I think I’m spiritually or eternally male.  It doesn’t even mean that I think that my body’s gender is necessarily ‘right,’ in the sense that it couldn’t be subject to change when my body is perfected.

So what does it mean then?

One of the few helpful things my bishop (in the LDS church the name for a lay, local church leader) said when I regrettably informed him about my desire to be female was that maybe looking at it in terms of God’s intentions would be helpful.  At the time, I felt like he was essentially saying “Look buddy, you’re male and that’s what God intended, so get used to it and get over it.”  Unfortunately, it’s very possible that that’s what he was saying, but there’s possibly a deeper meaning here, one that maybe the bishop didn’t intend.

Thinking about God’s intentions for me with the body I was given was actually enlightening, because I happen to also have been born with a congenital birth defect that is unrelated to any gender concerns or anatomy.  Fortunately, the defect is only cosmetic and I live in a first-world country, so when I was only a few months old it was repaired quickly and expertly.

God gave me a body with a significant birth defect.  God also gave me a body that was male.  Since I believe He knew what He was doing when He sent my spirit to this body, both my gender and my congenital birth defects were intentional – they weren’t mistakes.

But what does that mean, to know that God doesn’t make mistakes yet life is rife with imperfections?  Because here’s the thing – no one batted an eye when I went through surgeries to get the birth defect fixed.  No one stayed the surgeon’s hand, concerned that this was interfering with God’s intentions.  Why?  Because sometimes, bodies have problems.  Things go awry.  God is also apparently okay with some of His ‘intentions’ being fixed.  No one would have believed that the deformity I came with was indicative of my spiritual nature and that it was a characteristic of my eternal self.

Can the same thing be said about my body’s gender?  Both the birth defect and my body’s gender seem ‘defective’ to me.  Neither seems representative of my spirit or eternal self.  Read on to see how I’ve reconciled some of these conflicts and the personal decisions I’ve come to here.


2 responses

  1. Pingback: On hope (or the lack thereof) | Constellatum

  2. Pingback: On hope (and the fact that I still have some) | Constellatum

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